Organization Active NPI

Lifecare Family Chiropractic LLC

  • Chiropractor
  • Ellington, CT
National Provider Identifier
1376739524
Registry record updated Sep 21, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
001208 Issued in CT
Legal business name
LIFECARE FAMILY CHIROPRACTIC LLC
Practice address
105 West Rd
Ellington, CT 06029-5700
Phone
(860) 872-2070
Fax
(860) 872-2070
NPI assigned
Sep 21, 2007
Last updated
Sep 21, 2007By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 21, 2007

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Dr. Sean Noel, D.C.NPI 1235238643
Title
Owner
Phone
(860) 872-2070

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 001208 CT Primary

Addresses

Primary practice location

105 West Rd
Ellington, CT 06029-5700

Mailing address

105 West Rd
Ellington, CT 06029-5700
Phone (860) 872-2070

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CT

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20050128000544 CT Part B Supplier - Clinic/Group Practice 3476503210 Receives reassigned benefits from 1 practitioner
Practice locations: Ellington, CT

National Provider Directory

National Provider Directory

Locations

105 West Rd
Ste 7
Ellington, CT 06029
Phone (860) 872-2070

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1190332800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1190332800000",
    "number": "1376739524",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "105 WEST RD",
            "city": "ELLINGTON",
            "state": "CT",
            "postal_code": "060295700",
            "telephone_number": "860-872-2070",
            "fax_number": "860-872-2070"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "105 WEST RD",
            "city": "ELLINGTON",
            "state": "CT",
            "postal_code": "060295700",
            "telephone_number": "860-872-2070",
            "fax_number": "860-872-2070"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LIFECARE FAMILY CHIROPRACTIC LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-09-21",
        "last_updated": "2007-09-21",
        "status": "A",
        "authorized_official_last_name": "NOEL",
        "authorized_official_first_name": "SEAN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "860-872-2070",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "CT",
            "license": "001208",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ellington, CT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 21, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.